Active NPI
Aaya Khalil Qondah
- Behavior Analyst
- Olivette, MO
National Provider Identifier
1104417765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- B160288001
- Practice address
- 1320 Baur Blvd, Olivette, Mo 63132
Olivette, MO 63132-6307 - Phone
- (314) 528-9509
- NPI assigned
- Jan 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | B160288001 | MO | Primary |
Addresses
Primary practice location
1320 Baur Blvd, Olivette, Mo 63132
Olivette, MO 63132-6307
Mailing address
10975 Ridgecrest Dr
Saint Ann, MO 63074-3439
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B160288001 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611705600000",
"number": "1104417765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10975 RIDGECREST DR",
"city": "SAINT ANN",
"state": "MO",
"postal_code": "630743439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 BAUR BLVD, OLIVETTE, MO 63132",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631326307",
"telephone_number": "314-528-9509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QONDAH",
"first_name": "AAYA",
"middle_name": "KHALIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-27",
"last_updated": "2021-01-27",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "B160288001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olivette, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.